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Another soiled clothing vent

Posted

Specializes in School Nursing. Has 8 years experience.

Wondering why it takes an RN license to get this done (even though policy dictates otherwise, it is not followed through on). If a child urinates on his clothing, the procedure is that the parents are first called to bring a change of clothing. Only if they cannot be reached, or absolutely cannot come or send someone else, do we offer clothing. I have a few things in my office but most of the selection is kept by the counselor. Despite this, students are repeatedly referred to the nurse's office with this problem. We have a district memo that states that it is supposed to be a "team effort" and "designated staff members" are supposed to help so that "any one staff member is not over-burdened" by this. Well, I'm feeling over burdened.

Student is sent to me for urine accident. The phone numbers are kept in the main office, so I go there. The family is Spanish speaking only, so I ask the clerk to call for me. The numbers are not in service, and there are no different numbers under any of the student's siblings. So, on to plan B. I have a pair of shorts that will probably fit him, but no undies. My student who gets a cath shows up so I ask the clerk to call the counselor. Finish cath, counselor has undies but probably too small and she does not have the key to the cabinet.

I call counselor and determine that the kid is tiny and undies will probably fit well enough. She does not have keys to cabinet. I have to approach secretary for keys (who gives me attitude about it). Now if I am to retrieve the golden britches, I have to leave my office and travel upstairs, and I've got kids filing in and out. So now I track down the campus monitor to go get the undies for me. FINALLY after directing traffic for 30 minutes, the kid gets to change out of his wet pants.

Is it just me, or could this not be a whole lot easier if the teacher calls home, then refers to the counselor if no one can come? Two people involved instead of five? Does that make too much sense? OK, vent over. I feel better. Just glad my RN license is getting put to such good use!

It seems if it has ANYTHING to do with a bodily fluid, it is an automatic nurse duty. I have sort of resigned myself to it as part of the job. It just seems I am always so busy when I have to deal with it, an asthma attack or seizure or something! Poor kid has to wait until I have time to get around to him / her. Meanwhile, there are 3-4 able bodied people in the front office chit- chatting ( vent for another thread). At least I have some clothes in my clinic and I don't have to go roaming the building. I have a " community liaison" in my building who chair sits, seems like she could handle it easily but like you said......that would mean common sense!

Edited by SchoolNurseTXstyle
Not done

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

this goes back to the idea that i have alluded to before if the sinse of immediacy in a health office. sure - you don't want a kid sitting in soiled clothing for very long, especially when someone else could easily jump in and help the child, but the basic tenets of triage state that no... i am not leaving the child in the throes of an asthma attack because a child soiled themsleves.

I have been known to give a gentle reminder to staff bringing me the issue that the clean loaned clthes are in the closet - and can you please get the student started in changing while i handle this emergency?

mc3, ASN, RN

Has 12 years experience.

I feel your pain!!!

mc3:nurse:

Nurse ABC

Has 14 years experience.

I know how you're feeling! I do understand if a teacher is in the middle of class teaching it's hard for them to just stop everything to help that student with this issue but I so wish most teachers required their students (esp the younger ones) to keep a change of clothes in their backpack. The teachers and kids act like the nurse's office is Walmart sometimes and just constantly send kids down for even tiny things with a little mud or a little ketchup on them. Of course, it always happens when you're the most busy with really serious things going on!!

ask them "Do I look like Nurse P**1*s*s*Y PaNtS?

For some of the classes in the district I work for, teacher request a change of clothes for every student in the class, especially if they are pre-K through about 1st or 2nd grade, or for students who have special needs that might require a change of clothes. I don't see why parents can't be responsible for extra clothes (especially if they know their child may be remotedly prone to need them).

I constantly having kids in my office to change clothes. We have a good supply but are quickly running out. I even get kids who spill a little milk on themselves and want to change, 4th graders that is. I understand the occasional accident in the little ones, but when they start coming in because of a little spilled milk I start to wonder. The one thing I have to deal with is that I have a kindergarten little boy who cannot wipe himself after having a BM.....so the teacher brings him to my office bathroom to have a BM so I can wipe him when he is done. It has already happened twice and I am getting ready to have a meeting with both the teacher and parents. I just don't understand why they think it is my responsibility to wipe this kiddo, I feel that he should be able to do this. Maybe I am just a little frustrated.

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

it's not your responsibility to wipe a kid's behind. Unless there is some disability, the child should have the skills to perform such a self care task. It sounds like the parents need to spend a weekend training this at home and perhaps equip their child with a small pack of wet wipes for school.

Maybe this is one of the blessings for me having to be the nurse at 11 campuses .. .the staff has to handle it as the nurse simply can't be everywhere at once.

The school secretaries have the key to the med supply cabinet and the extra clothes. I've never had to deal with it.

HorizonRN

Has 3 years experience.

The frustrating thing about the school environment is that people don't seem to understand the fact that we prioritize. Everything is a big deal for the teachers and other staff and they think that I am ignoring them when I attend to the most pressing issues first.

mc3, ASN, RN

Has 12 years experience.

What really gets me is the teacher that sends the child to the clinic, with their extra clothes in hand! Is my bathroom more special than yours? geesh! The little kids have a Teachers Aide in each class; that is part of their job (really!).

I've started a new thing this year, and it seems to help. I do give the little ones (Pre-K through 2nd) extra clothes for accidents and spills. For the older ones, especially for spilled milk or juice (sometimes even water) I hand them a bunch of paper towels and tell them how to clean themselves up. We also have a dress code - no spagetti straps, midriff covered, skirts no shorter than 2" above the knee, etc. I got tired of giving these kids clothes - the parents sign an agreement at the beginning of the year acknowledging they understand the dress code. So, when I get "violators" :), I call the parent or, if the child is 4th or 5th grade, I have them call the parents themselves to bring a replacement it. That's the only way that seems to work; it makes an impression on the parent when they have to come bring clothing in!

For the ones with "wiping" problems, I get a baby wipe for them and ask if they can do it themselves. I don't do nooks and crannies :). If it's that bad, they probably need a bath anyway, and I call home and tell Mom. I never, ever, ever, change a child without a witness present the whole time.

:nurse:

What really gets me is the teacher that sends the child to the clinic, with their extra clothes in hand! Is my bathroom more special than yours? geesh! The little kids have a Teachers Aide in each class; that is part of their job (really!).

If you are talking about teacher assistants, then it is not their job either (at least not in my school district). I am a teacher assistant in a public school that specializes in educating children with special health and mental needs (this is sort of an inclusion school). I am not allowed to change a child if they have an accident, so I have been told. If a student has an accident, as far as I know of I would be the one to call the parents while the teacher continues to teach class.

We have a number of CNAs and medical assistants to assist certain students. Some students have their own nurse for their needs (the school district has a contract with a home health company). We have a couple of classes for students who have severe disabilities that cause them to be low functioning. They are in a special class for most of the day. They have CNAs to change them if needed.

I feel you pain. Reading everyone's stories makes me feel like at least I'm not the only one wondering if an RN license is really necessary to change diapers.

missfixit

Has 14 years experience.

Obviously, when we added the title RN or LPN behind our names we also became more qualified to deal with urine/bm accidents. :sarcastic: I have just tried to except it- to a certain degree. This is what I do. I ask for the teachers to request a change of clothes for students pre-k - 5k- if a student brings in clothes, the clothes stay in their bookbag. A few of the teachers will go ahead and send them to the restroom to clean up/change. They have bathrooms in their classrooms-- I do not have a bathroom in my office.

All of the extra clothes are in my office. That way you are not running all over the place to get clothes. Because lets face it, no matter what they are going to keep coming to you for a solution. If a student shows up for urine/BM accident- I call a parent and ask them to bring clothes and help their child get cleaned up. If I can't reach anyone or the parent refuses - I tell the students exactly what they need to do to get cleaned up. I do not clean the children myself. Maybe if the student takes responsibility for the accident, they are less likely to continue having "accidents".

As far as wiping the 5k student after his bm's-- NO WAY!!

I guess many teachers send bm/urine accidents to the nurse because in many school districts the teacher nor the teacher assistant is allowed to help with a bathroom accident, not because they just want to ruin the nurse's day ;)!

How funny - we had a 1st grader today who wet his pants and we sat him on a chair and called his mom, who came to take him home and change. Then he came back and went to class.

We cleaned up the chair after he left.

MinnieMomRN

Specializes in Med-Surg; Telemetry; School Nurse pk-8.

Yes, it's begun again this year. I've already had the teacher of the Pre-K age 3 classroom pull me out of a meeting for a 'crisis'. That crisis was that she had three kids who had messed their pants, and she couldn't find the janitor.

Of course, thinking that maybe we might have a GI bug circulating, I asked if the kids seemed ill. Were the BM's loose, watery or foul-smelling. "No, they are normal", she answered, "I just need someone to clean up the bathroom and the school secretary can't find the janitor, so I got you"!

No... I did NOT stay and clean her bathroom.